TL;DR
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In a Nov. 1, 2026, opinion article, psychiatrist Devina Wadhwa argues that clinicians should distinguish ordinary responses to loss and hardship from psychiatric disorders without overlooking serious illness. She says screening questionnaires can help identify symptoms but cannot replace an assessment of a patient’s circumstances, functioning, symptom course and safety.
Psychiatrist Devina Wadhwa argues that mental health clinicians should not treat screening results or symptoms alone as proof of a psychiatric disorder, calling for assessments that account for a patient’s circumstances, functioning and safety. In an opinion article published Nov. 1, she says the distinction matters because grief and hardship can produce symptoms that overlap with illness, while people facing those events can also develop conditions that need treatment.
Wadhwa describes people who struggle to sleep after a relationship ends, lose their appetite while grieving, or become anxious and unable to concentrate after losing a job. Such symptoms can appear in psychiatric disorders, she writes, but they can also be responses to painful events. Sadness, worry, insomnia and poor concentration do not by themselves settle what a person is experiencing.
She points to questionnaires such as the PHQ-9 and GAD-7 as tools that can indicate depressive or anxiety symptoms. But she cautions that a screening result is not a substitute for a clinical assessment. Brief appointments and telehealth evaluations may make it harder to understand the circumstances behind a person’s answers, she argues; the tool should not become the whole evaluation.
Wadhwa does not argue that distress should be left untreated or that a clear life event rules out illness. She says grief can coexist with major depression, and severe symptoms after a loss still call for careful assessment. Clinicians, she writes, should ask what happened, how long symptoms have lasted, how much functioning has changed, whether the response is evolving, and whether the patient may be at risk.
Why Context Changes Diagnosis
The distinction can affect how patients understand their experiences and what care they receive. Wadhwa writes that a diagnosis can give people language for symptoms and guide treatment, but it can also shape the story they tell themselves about what is happening. A response to loss and a psychiatric disorder are not interchangeable labels, although both can be present.
Her argument is for care that avoids two errors: treating every painful emotion as illness, and dismissing serious symptoms as an understandable reaction to a difficult event. Missing a disorder may leave a patient without needed support; applying a diagnosis without enough context may misrepresent their experience. Clinical judgment has to hold both possibilities, rather than letting a checklist decide between them.
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Screening Tools and Clinical Judgment
Psychiatry assesses experiences such as sadness, worry, sleep disruption and appetite changes that can occur both in mental illness and in everyday responses to events. That overlap makes context relevant to interpretation. Wadhwa notes that diagnosis can help focus treatment, and says she has seen medication, psychotherapy, hospitalization and other interventions change or save lives.
Her article is an opinion piece by a practicing psychiatrist, not a study reporting new data or a change to diagnostic guidance. It does not quantify how often clinicians overdiagnose normal distress, nor does it establish that screening tools generally produce inaccurate diagnoses. Its central recommendation is that clinicians use those tools as part of a broader assessment, not in place of one.
Where Distress Becomes Disorder
Wadhwa says there is no simple answer to when grief or another response to hardship should be understood as a psychiatric disorder. The article does not offer a new diagnostic threshold, a decision rule or evidence measuring how often normal distress is diagnosed as illness. It also does not claim that screening questionnaires are inherently unsuitable; the concern is that they may be used without enough context.
In an individual case, the duration and severity of symptoms, changes in daily functioning, the person’s prior history and any safety risks can all matter. The article does not set out a universal way to weigh those factors. That judgment remains clinical and depends on the patient’s circumstances.
Questions for Ongoing Assessment
Wadhwa calls on psychiatrists to keep asking about what happened, how symptoms are changing, how daily life has been affected and whether the patient is at risk. Her proposed next step is not a new test or diagnostic category, but an assessment that gives enough time to understand the person behind the screening results.
The article does not announce a policy change or a scheduled follow-up. Its practical message is to use symptom tools alongside conversation and clinical judgment, while taking severe or worsening symptoms seriously. Whether an experience is distress, disorder or both may become clearer over time and through continued assessment.
Key Questions
Is Wadhwa saying grief should not be diagnosed or treated?
No. She says grief and major depression can coexist, and that severe symptoms following a loss still require assessment. Her point is that grief-related symptoms do not automatically establish a depressive disorder.
What does the article say about mental health questionnaires?
Wadhwa treats questionnaires such as the PHQ-9 and GAD-7 as potentially useful tools for identifying symptoms, but says they should not replace an assessment of circumstances, functioning and risk.
How does the article suggest clinicians assess distress?
It recommends asking what happened, how long symptoms have lasted, how much functioning has changed, whether symptoms are evolving and whether the patient is at risk. Wadhwa also says clinicians should consider what the person was like before the event.
Does the article provide evidence that overdiagnosis is widespread?
No. It is an opinion article that raises concerns about diagnosing without sufficient context. It does not present new research, prevalence estimates or data on how often clinicians overdiagnose distress.
Source: medpagetoday.com
